Letter to the Editor: “Impact of clinical information on CT diagnosis by radiologist and subsequent clinical management by physician in acute abdominal pain”
by Julián Guerra, Camilo Soler, María Alejandra Rueda (mariarueda91@gmail.com )
Impact of clinical information on CT diagnosis by radiologist and subsequent clinical management by physician in acute abdominal painDear Editor,
We read thoroughly the article entitled “Impact of clinical information on CT diagnosis by a radiologist and subsequent clinical management by a physician in acute abdominal pain” by S. Hattori et al. [1]. We found it very interesting, considering it can give us the scientific support to reach a consensus with attending physicians. At our institution, University Hospital Fundación Santa Fe de Bogotá, Colombia, it is pretty common to have imaging requests with incomplete clinical information and even with no information at all. This makes it more time-consuming for radiologists and radiology residents and lengthens the lecture times by checking the clinical records to acquire the necessary medical information, primarily the clinicians’ suspected diagnostic. Particularly in the night shifts, this lack of communication makes radiology lectures inefficient because of longer interpretation times per study. Consequently, this conditions the patients’ attention and management in the emergency department, given we have pre-established lecture times and should not exceed one hour.
It would be interesting for your study to perform an intraobserver kappa analysis after a prudential time to avoid memory and recall bias and evaluate if there is a change in diagnosis and lecture times for each radiologist.
It could also be essential to know if having clinical information impacts incidental findings that could be relevant in the clinical context of the patient given satisfaction bias. For example, in the study by Littlefair et al., they demonstrated that having previous expectations before lectures can impact the diagnosis efficiency and assign false positives in regular studies [2].
Lastly, a subgroup analysis could be performed depending on the type of study, with or without contrast, since some diagnosis is harder to make in a simple CT. Having the appropriate clinical information and suspected diagnosis could lead to more guided studies to better address the clinical inquiry.